Trauma-Informed Parenting: APPENDICES

APPENDIX A

Defining Trauma and Child Traumatic Stress Trauma Children and adolescents experience trauma under two different sets of circumstances. 1. Some types of traumatic events involve (1) experiencing a serious injury to yourself or witnessing a serious injury to or the death of someone else, (2) facing imminent threats of serious injury or death to yourself or others, or (3) experiencing a violation of personal physical integrity. These experiences usually call forth overwhelming feelings of terror, horror, or helplessness. Because these events occur at a particular time and place and are usually short-lived, we refer to them asacute traumatic events. These kinds of traumatic events include the following: • • • • • • •

School shootings Gang-related violence in the community Terrorist attacks Natural disasters (for example, earthquakes, floods, or hurricanes) Serious accidents (for example, car or motorcycle crashes) Sudden or violent loss of a loved one Physical or sexual assault (for example, being beaten, shot, or raped)

2. In other cases, exposure to trauma can occur repeatedly over long periods of time. These experiences call forth a range of responses, including intense feelings of fear, loss of trust in others, decreased sense of personal safety, guilt, and shame. We call these kinds of trauma chronic traumatic situations. These kinds of traumatic situations include the following: • • • •

Some forms of physical abuse Long-standing sexual abuse Domestic violence Wars and other forms of political violence

Child Traumatic Stress Child traumatic stress occurs when children and adolescents are exposed to traumatic events or traumatic situations, and when this exposure overwhelms their ability to cope with what they have experienced. Depending on their age, children respond to traumatic stress in different ways. Many children show signs of intense distress! disturbed sleep, difficulty paying attention and concentrating, anger and irritability, withdrawal, repeated and intrusive thoughts, and extreme distress! when confronted by anything that reminds them of their traumatic experiences. Some children develop psychiatric conditions such as posttraumatic stress disorder, depression, anxiety, and a variety of behavioral disorders. While some children "bounce back" after adversity, traumatic experiences can result in a significant disruption of child or adolescent development and have profound long-term consequences. Repeated exposure to traumatic events can affect the child's brain and nervous system and increase the risk of low academic performance, engagement in high-risk behaviors, and difficulties in peer and family relationships. Traumatic stress can cause increased use of health and mental health services and increased involvement with the child welfare and juvenile justice systems. Adult survivors of traumatic events may have difficulty in establishing fulfilling relationships, holding steady jobs, and becoming productive members of our society. Fortunately, there are effective treatments for child traumatic stress.

Found at: http://www.nctsn.org/content/defining-trauma-and-child-traumatic-stress

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APPENDIX B Life Events that can be Traumatizing Remember: An event which is very traumatic to one child may have little or no impact on another. As Peter Levine stated, “Trauma is not in the event itself; rather, trauma resides in the nervous system [of the victim].”

Potentially traumatizing events can be divided into two main categories: Acute traumatic events; and Chronic traumatic events. I. Acute traumatic events – events that occur at a particular time and place and are usually limited to one or two occurrences, and would include the following: • Being given up for adoption • Death or other loss of a loved one or pet • Gang-related violence • Terrorist attack • Natural disasters ! earthquakes, floods, hurricanes, fires, tornados, tsunamis • Serious accidents ! car crash, falls • Witnessing a serious accident, injury or death of another person • Physical assault • Sexual assault • Living in dangerous environment • Loss of home ! fire or financial • Loss of employment • Divorce • Moving away from family or friends • DCFS involvement, removal, placement in foster care, etc. • Legal difficulties • Suicide by family member or other significant individual • Home invasion or burglary • Airline, train, ship hijacking or accidents • Hospitalization • Pre and perinatal birth trauma • Invasive medical procedures

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II. Chronic traumatic events • Recurrent physical abuse • Recurrent sexual abuse • Ongoing neglect • Sexual trafficking • Domestic violence over time • Wars and other forms of political violence • Single parenting • Ongoing bullying • Emotional/verbal abuse • Racism • Discrimination • Interracial violence • Poverty • Homelessness • Repeated terrorism • Alcohol and/or drug abuse in the home • Incarceration of family member • Chronic physical or mental illness of caregiver • Living as a refugee • Political oppression or human rights abuses • Living in dangerous circumstances • Serious burns or other lingering physical difficulty • Loss of mobility • Stalking • Torture • War • Chronic illness • Chronic pain • Military service • Child is missing or has run away (traumatizing for parents, child and family members) • Parent yelling, loud noises (for children with sensory processing disorder)

Note: This list does not cover all potentially traumatizing life events.

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APPENDIX C What’s My ACE Score? Prior to your 18th birthday: 1. Did a parent or other adult in the household often or very often" Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt? Yes No If yes enter 1

________

2. Did a parent or other adult in the household often or very often" Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured? Yes No

If yes enter 1

________

3. Did an adult or person at least 5 years older than you ever" Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you? Yes No If yes enter 1

________

4. Did you often or very often feel that " No one in your family loved you or thought you were important or special? or Your family didn# t look out for each other, feel close to each other, or support each other? Yes No If yes enter 1 ________ 5. Did you often or very often feel that " You didn# t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it? Yes No If yes enter 1 ________ 6. Was a biological parent ever lost to you through divorce, abandonment, or other reason ? Yes No If yes enter 1 ________

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7. Was your mother or stepmother: Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife? Yes No If yes enter 1 ________ 8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs? Yes No If yes enter 1 ________ 9. Was a household member depressed or mentally ill, or did a household member attempt suicide? Yes No If yes enter 1 ________ 10. Did a household member go to prison? Yes No

If yes enter 1

________

Now add up your “Yes” answers: _______ This is your ACE Score

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APPENDIX D Signs and Symptoms of Psychological Trauma Every child’s response to their ACEs or other traumas is unique to them: ¸ Not all children who experience traumatic events will develop symptoms of child traumatic stress. Some children seem able to “bounce back” and move on with little negative affect. ¸ Other children seem to be more heavily impacted by their ACEs and they may manifest a wide array of negative outcomes: ¸ Note: This list does not cover all potential effects of ACEs or other childhood traumas • • • • • • • • • • • • • • • • • • • • • • • • • • •

Acting out the traumatic event during playtime ADHD like behaviors Aggression Anger Anxiety or stress Behavior problems Being unusually clingy with a parent or other adult Bullying others Change of appetite ! eats very little; eats constantly Cognitive difficulties Complaints of aches and pains Confusion Crying Depression or worrying Difficulty concentrating or thinking rationally Difficulty learning or remembering Difficulty making friends Difficulty with closeness Disorientation Dissociation ! $ Zoning out,% shutting down, $ day dreaming,% Drug or alcohol abuse or addiction Easily startled Emotional detachment Explosive emotional outbursts Extreme neediness Helplessness Extreme bouts of distress Extreme separation anxiety 7

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

Fatigue and exhaustion Fear of a particular person or type of person ! the abuser or individuals who resemble the abuser in some way Fears Feelings of powerlessness Fidgety, or edgy Fighting $ Flashbacks% to the traumatic events Guilt Helplessness Hoplessness Impulsive behaviors Inability to concentrate Insomnia Intense mood swings Irritability Loss of interest in previously enjoyable activities Nightmares Numbing Obesity Obsessive compulsive behaviors Obsessive thoughts of bad things Oppositional or defiant behaviors Overwhelming fear Panic attacks Paranoia Reactive attachment disorder (RAD) ! inability to connect with others in a healthy manner Refusing to go to school Regressive behaviors ! return to sucking thumb, bedwetting, behaving like a younger child Self-harm ! i.e., cutting Suicidal thoughts or behaviors Sexualized behaviors Shame Social isolation and withdrawal heartbeat Trust issues Victim of bullying Tachycardia ! rapid. 8

APPENDIX E

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APPENDIX F

What do You See?

If you cannot see the 3-D image of a triceratops diaosour, you might have difficulty looking beyond your child’s bad behaviors to focuis on the person there, behind the behavior.

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